The Comparison Of Pethidine Intramuscule Injection And Diclofenac Sodium Suppositories In The Analgesic Effect On Postsurgical Spastic Bladder Pain

Background investigation and purpose:Tumor of bladder is the most common malignant tumor in urinary system.At present,among all the tumor the bladder carcinoma attack rate is the 8th place in male and the 12th place in female in china.With the rapid development of science and technology,most of patients choose transurethral bladder turner resrction as a good surgical approach.Postsurgical spastic bladder pain becomes one of the most common complications.To relieve the spastic bladder pain,we usully choose pethidine intramuscule injection or diclofenac sodium suppositories,either method can be used for relieving the pain.But the effect has some difference.Here we compare the analgesic effect of these two methods on relieving the spastic bladder pain.Samples and research methods:50 patients with had different levels of spastic bladder pain were treated with either pethidine intramuscule injection or diclofenac sodium suppositouium during 2009.2-2009.5 to compare their analgesic effect.1.pethidine:a phenyl-piperidine derivatives,is a most common synthetic analgesics in clinical,active on u-size opioid receptors,has the same pharmacological action as morphine.but the analgesic effect weak than morphine,has a 1/7-1/10 potency than morphine,application time shorter than morphine,but the sedative action,respiratory inhibition,euphoriant effect and vasodilative effect as same as morphine.2,diclofenac sodium suppositouium,a nonsteroidal antiinflammatory drug,the analgesic effect in the way of inhibitory action of cyclooxygenase(COX)to reduce prostaglandin(PG) composition.Also has some effect on inhibitory of lipoxygenase to reduce leukotriene,bradykinin(BK).the patients become more sensitive to spastic bladder pain.The patients were divided into two groups randomly of which one group was treated with pethidine,the other was treated with diclofenac sodium suppositouium,and VAS was applied to assess the pain lever 30min,1h,2hand4h after the treatment.Results:In the 24 patients treated with pethidine 21 patients had relief in pain,amang which 14 patients had relief in pain obviously within 30min,4 patients had relief in pain obviously during 30min and 1h,2 patients had relief in pain during 1h and 2h,1 patient had relief in pain during 2h and 4h,3 patients had relief in pain slightly.3patients in the pethidine treated group were stopped using pethidine becauses an obvious decline in analgesic effect after continuously application of pethidine every other 24h was observed.2.Diclofenac sodium group:20 patients had relief in pain in 26 patients;in these 20 patients,there are 5 patients had relief in pain obviously in 30min,9 patients had relief in pain obviously during 30min and 1h,4 patients had relief in pain during 1h and 2h,2 patients had relief in pain during 2h and 4h,6 patients had relief in pain slightly.Relieve pain obviously means the pain decrease six points or sleep quitly;relieve pain means the pain decrease more than 4 points but less than 6 points;relieve pain slightly means the pain decrease less than 2 points.Conclusion:1.Pethidine have a rapid,good effect in relieving postsurgical spastic bladder pain.2.Pethidine is not recommended to be applied continuously in treating postsurgical spastic bladder pain due to the decline of its analgesic effect and its side effect of respiratory inhibition.Adversely,the diclofenac sodium suppositouium can be applied repeatedly due to avoidance of gastrointestinal side effect particularly because it is via rectal administration.